Individual
AMANDA MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 EDWARDS ST STE 1, MORRIS, IL 60450-1692
(815) 942-1421
(815) 942-5487
Mailing address
1345 EDWARDS ST STE 1, SUITE 1, MORRIS, IL 60450-1692
(815) 942-1421
(815) 942-5487
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.438522
IL
363LF0000X
Family Nurse Practitioner
Primary
209025828
IL
Other
Enumeration date
07/06/2022
Last updated
10/23/2025
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